{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:19:12Z","timestamp":1792671552865,"version":"4.5.0"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Scrub typhus is an acute febrile illness widely prevalent in the \u2018tsutsugamushi triangle\u2019 region of the world. Clinical features include fever, myalgia, headache, rash, and a pathognomonic eschar. An eschar is formed by the bite of chigger mite that inoculates the causative agent of Scrub typhus\n                      <jats:italic toggle=\"yes\">Orientia tsutsugamushi<\/jats:italic>\n                      . The aim of this study is to determine the most common sites of eschars over the bodies of patients with Scrub typhus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>In a retrospective analysis, we examined a total of 418 patients who presented to Christian Medical College, Vellore between 2009 and 2012 with an acute febrile illness and an eschar on clinical examination and confirmed to have scrub typhus with a positive Scrub typhus IgM ELISA test. We studied the distribution of eschars over the bodies of 418 patients with Scrub typhus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There was a significant difference in the distribution of eschars between males and females with a preponderance of the chest and abdomen (42.3%) among females and the axilla, groin and genitalia (55.8%) in males. Some unusual sites of an eschar were the cheek, ear lobe and dorsum of the feet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The eschar is the most useful diagnostic clue in patients with acute febrile illness in areas endemic for Scrub typhus and therefore should be thoroughly examined for its presence especially over the covered areas such as the groin, genitalia, infra-mammary area and axilla.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0022-3859.118033","type":"journal-article","created":{"date-parts":[[2013,9,12]],"date-time":"2013-09-12T04:17:55Z","timestamp":1378959475000},"page":"177-178","source":"Crossref","is-referenced-by-count":55,"title":["Eschar in scrub typhus"],"prefix":"10.4103","volume":"59","author":[{"given":"AP","family":"Kundavaram","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AJ","family":"Jonathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SD","family":"Nathaniel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GM","family":"Varghese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-3-20240205","doi-asserted-by":"crossref","first-page":"162","DOI":"10.4269\/ajtmh.2002.67.162","article-title":"Scrub typhus in Japan: Epidemiology and clinical features of cases reported in1998","volume":"67","author":"Ogawa","year":"2002","journal-title":"Am J Trop Med Hyg"},{"key":"R2-3-20240205","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.3201\/eid1210.051697","article-title":"Scrub typhus in Himalayas","volume":"12","author":"Mahajan","year":"2006","journal-title":"Emerg Infect Dis"},{"key":"R3-3-20240205","first-page":"154","article-title":"Atypical eschar sites in scrub typhus in sub-Himalayas","volume":"57","author":"Aggarwal","year":"2009","journal-title":"J Assoc Physicians India"},{"key":"R4-3-20240205","doi-asserted-by":"crossref","first-page":"S137","DOI":"10.1016\/j.jaad.2004.03.036","article-title":"Rickettsial pox: Report of three cases and a review","volume":"51","author":"Saini","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"R5-3-20240205","doi-asserted-by":"crossref","first-page":"806","DOI":"10.4269\/ajtmh.2007.76.806","article-title":"Distribution of eschars on the body of scrub typhus patients: A prospective study","volume":"76","author":"Kim","year":"2007","journal-title":"Am J Trop Med Hyg"}],"container-title":["Journal of Postgraduate Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00005257-201359030-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:39:24Z","timestamp":1786649964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00005257-201359030-00003"}},"subtitle":["A valuable clue to the diagnosis"],"short-title":[],"issued":{"date-parts":[[2013]]},"references-count":5,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.4103\/0022-3859.118033","relation":{},"ISSN":["0022-3859"],"issn-type":[{"value":"0022-3859","type":"print"}],"subject":[],"published":{"date-parts":[[2013]]}}}